Acute gastrointestinal bleeding in the intensive care unit - The gastroenterologist's perspective

Gastrointestinal bleeding in the intensive care unit (ICU) may result from stress related erosive syndrome (SRES) and nonocclusive mesenteric vasculopathy (NOMV). A relative reduction in mesenteric perfusion that occurs in the critically ill patient contributes to the pathogenesis of both diseases. Advances in ICU management have resulted in a decrease in the incidence of SRES and NOMV. In addition, prophylactic pharmacologic therapy with antacids or acid suppressive therapy has contributed in part to the considerable reduction in the incidence; of SRES. Nevertheless, for SRES and NOMV, treatment of the underlying disease remains the most important factor in prevention.